Non-invasive Ventilation (NIV) for use at home

Non-invasive Ventilation for use at home

Please keep this leaflet with your machine as it contains useful information about your treatment. This will be very useful if admitted to hospital or you become unwell.

Non-Invasive ventilation (NIV) is a treatment to help with your breathing. It involves wearing a mask connected to a machine which makes breathing in and out easier and supports the muscles which make your lungs work. It is generally worn at night during sleep.

The mask provided has been specifically selected to fit your face and the machine has been specifically set for your breathing, based upon blood tests either in hospital or in clinic. The details of these are recorded below. Please keep this information as it will be useful to sort out any problems.

Why has this treatment been recommended?
NIV can improve your sleep quality leading to better energy and concentration levels during the day. It can help you feel less breathless than before. This may mean you may be able to perform more daily tasks. You may feel brighter on waking and headache free if this was a problem before. It can also decrease the likelihood of being re-admitted to hospital

You have been issued:

• Machine (with power lead)
• Filter
• Hose
• Mask (with headset)
• Carrying bag

You will be shown how to use your equipment, fit your mask and care for your equipment.  Cleaning guidelines are included with this leaflet.

PLEASE BRING YOUR EQUIPMENT TO EVERY APPOINTMENT

Useful Information

How to switch the machine on and off
Connect the cable into the power inlet on the rear right hand side of the machine. Please be aware the surround of the power connection may have a retention clip which locks the power cable into place if pressed down. The retention clip can be lifted upwards in order to unlock the power cable for easier transport. Plug the machine into the mains and it will automatically come on and the screen will light up.

At the rear of the machine is the air outlet, where you may attach an external filter if given one by your respiratory nurse, and then attach the hose from your mask.

To switch the machine on or off simply press the start/stop button once which is located in top of the device. Some patients have “Smart Start” which means you do not need to press any buttons.

Once the device has been running for a few minutes all lights on the machine will go off but pressure will still be delivered.

Cleaning your machine and mask

Daily: Mask cushion and frame
It is important that you hand wash the cushion and frame daily with cheap washing up liquid and warm water, and rinse thoroughly. Allow masks to air dry out of direct sunlight or heat source. The more you look after your mask the longer it will last. Each cushion should last around 12 months if you have a mask with a grey foam insert, wipe it over daily with the wipes provided by the respiratory nurses, do not use other wipes.

Weekly: Headgear, Tube, Humidifier (if applicable), filters
Wipe over headgear, but do not let it get too wet or the Velcro will move. Wash the tube in warm soapy water, rinse thoroughly and shake off all excess water. Hang the tubing vertically to allow all water to drain and dry completely.

Humidifier: Descale the tub weekly with white vinegar or lemon juice and rinse well.

Leave to air dry. DO NOT USE ANTIDISCALANT CHEMICALS.

Filters: Black foam filters can be washed and air dried once a week and need changing once a year.

White filters must not get wet but can be wiped over weekly and changed every 6 months.

Some patients who have allergies may have small fine filters and this must not get wet and should be changed every 2 months.

The team will provide you with the correct equipment for you and your machine.

NIV Machine
Wipe the machine each week or sooner if dusty. Make sure the electricity is switched off first. Do not use any cleaning agents on the machine. Ensure the machine is completely dry before reconnecting the power supply.

FAQs

Q: Can I survive a night without my ventilator?
A: Yes, most patients can spend one or two nights off their machine. They won’t be very comfortable and symptoms of tiredness and headache may reappear- but rarely this will be dangerous. This is not recommended and you should contact the Respiratory Nurses if you do not wish to continue with treatment

Q: Does my ventilator need servicing?
A: No, but it is important you bring your machine, tube and mask to every appointment so we can check it over and download your data. New filters, mask and tubing will be checked and maybe changed if needed.

Q: When should I wear my ventilator?
A: You need to wear the ventilator overnight while you are asleep each night. If you want to have a nap in the day or have a chest infection, it may be good to use your ventilator during the day as well as the night. You won’t become dependent on it- but you will gain relief from wearing it.

Q: Do I need to bring my ventilator in the ambulance if I am admitted to hospital?
A: Yes, Yes, Yes! You must insist that your NIV machine come with you to hospital. You may need it and there may not be a NIV machine available at the hospital.

Q: Can I suffocate if the power goes off?
A: No, all our masks have a safety valve on them and an exhalation port so you will still be able to breathe if the machine isn’t working. It is important these don’t get blocked. You will probably sense the machine not working anyway and so you can take the mask off.

Q: What should I do if my ventilator stops working?
A: Most people can cope with a night or 2 off their NIV.  You may find symptoms of tiredness or headaches may appear but these should resolve once you restart using your machine. If there is still a problem contact the Respiratory Nurses, or Ward 5 at Alexandra Hospital who may be able to help.

Q: Is there anyone I can contact out of hours if there is problem with breathing?
A: No, we do not have the resources to provide an on-call service. If you feel your breathing is getting worse, or you are more unwell, call your GP or out of hours service and they may refer you to hospital to be seen by a medical expert.

Q: Can I use oxygen whilst on my ventilator?
A: Yes, some people may already have oxygen with your ventilator. Not all people need additional oxygen. The Respiratory nurses will be able to let you know if you need additional oxygen.

Common Problems

Mask seal problems
A small leak from the bottom of the mask is common and will not affect the performance of the NIV. However, a large leak into the eyes can be problematic. This can be caused because the mask doesn’t fit properly or is too tight. Try adjusting the head straps. You may need to contact the Respiratory Nursing team who are experts and can adjust your current mask or trail a different style. Sometimes it can take a number of attempts to find the best mask which is comfortable and effective.  Mask seal problems can also happen when incorrect cleaning methods are used and or frequency of washing.

Soreness on the nasal bridge
Soreness on the nose is an indication that the mask is too tight or a poor fit. The mask will need refitting or replacing as soreness can become worse overtime. Please contact the Respiratory Nurses to arrange an appointment. Please do not just turn up.

Throat and Mouth Dryness
Make sure you drink enough fluids during the day. Having a glass of water at the side of the bed may help during the night. If symptoms persist and you are unable to use your machine due to the dryness, then please contact us as we may be able to attach a humidifier to your NIV to moisten & warm the air.  This can reduce the dryness.

Nasal Problems
It is common to suffer from nasal stuffiness, or sneezing and a running nose when you first start treatment. This should settle on its own. If it doesn’t settle contact your GP and ask to trial a nasal spray.

Bloating
If you feel you may have trapped air or you are belching regular, then take some peppermint tea before bed or in the morning. If symptoms persist then please contact your GP. It may also mean your settings need to be checked and you would need to contact the Respiratory Nurses to help you with this.

Magnet Masks- Warnings
Please let your respiratory nurse know if you or your bed partner have a pacemaker or any other implantable devices, as the masks which have magnet connectors will not be suitable for you and could cause you potential harm or your bed partner. We have many different masks which we can trial to find the most suitable for you.

Contact Details

If you have any problems with any of the equipment you have been issued or you need to change an appointment, then please don’t hesitate to contact the Respiratory Nurses.

Redditch Respiratory Nurses                                                01527 503887
Worcester and Kidderminster Respiratory Nurses           01905 760255

This is an answer machine but we aim to pick up messages regularly during the day.

We are not a 24 hour service and work Monday – Friday 8.30–4.30 (except bank holidays).

If you are unwell please contact your GP or if severely unwell contact 999

If your symptoms or condition worsens, or if you are concerned about anything, please call your GP, 111, or 999.

Patient Experience
We know that being admitted to hospital can be a difficult and unsettling time for you and your loved ones. If you have any questions or concerns, please do speak with a member of staff on the ward or in the relevant department who will do their best to answer your questions and reassure you. 

Feedback
Feedback is really important and useful to us – it can tell us where we are working well and where improvements can be made. There are lots of ways you can share your experience with us including completing our Friends and Family Test – cards are available and can be posted on all wards, departments and clinics at our hospitals. We value your comments and feedback and thank you for taking the time to share this with us.

Patient Advice and Liaison Service (PALS)
If you have any concerns or questions about your care, we advise you to talk with the nurse in charge or the department manager in the first instance as they are best placed to answer any questions or resolve concerns quickly. If the relevant member of staff is unable to help resolve your concern, you can contact the PALS Team. We offer informal help, advice or support about any aspect of hospital services & experiences.

Our PALS team will liaise with the various departments in our hospitals on your behalf, if you feel unable to do so, to resolve your problems and where appropriate refer to outside help.

If you are still unhappy you can contact the Complaints Department, who can investigate your concerns. You can make a complaint orally, electronically or in writing and we can advise and guide you through the complaints procedure.

How to contact PALS:
Telephone Patient Services: 0300 123 1732 or via email at: wah-tr.PALS@nhs.net

Opening times:
The PALS telephone lines are open Monday to Friday from 8.30am to 4.00pm. Please be aware that you may need to leave a voicemail message, but we aim to return your call within one working day.

If you are unable to understand this leaflet, please communicate with a member of staff.